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Generate impression based on medical findings. | Abnormal LFTs LIVER: Coarse echogenic liver echotexture without mass. Liver length 17.5 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9.6 cm in lengthOTHER: Spleen 7.9 cm in length. No ascites | Coarse echogenic liver echotexture suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on medical findings. | Female, 47 years old.Reason: r/o ptx, assess for infection, edema History: hypoxia, resp failure Marked left hemidiaphragm elevation, new since 9/24/2015, with overlying atelectasis and a gas distended stomach below. Right lung unremarkable.A Dobbhoff tube terminates in the stomach.ET tube tip approximately 5 cm above the carina.Extensive skeletal metastases unchanged. | Increased left hemidiaphragm elevation with overlying atelectasis. |
Generate impression based on medical findings. | Female, 59 years old.Reason: ET tube position History: intubated ET tube tip is 2 cm above the carina. Left internal jugular central venous catheter tip is in the SVC. NG tube courses below the field-of-view. Multiple rib deformities compatible with healing fractures from metastatic involvement of multiple myeloma.Cardiomediastinal silhouette is normal.Large lung volume suggestive of COPD.No pleural effusion or pneumothorax. | ET tube is in appropriate position. |
Generate impression based on medical findings. | Neutropenic fever Scattered mild nodular opacities without new superimposed focal airspace abnormality. No effusions.Cardiac silhouette remains borderline enlarged with moderate tortuosity of the aorta.Extensive shoulder degenerative changes bilaterally | No specific evidence to suggest an acute infection or edema superimposed upon previously identified questionable mild nodular changes. Follow-up CT evaluation is suggested for further characterization given the neutropenic history and absence of of similar findings in mid January.Misha in the ER called |
Generate impression based on medical findings. | Reason: evaluate for new infiltrates History: soboe Unremarkable cardiac and mediastinal silhouette. Mild lower zone interstitial opacity, greater on the right, has slightly improved compared to previous, with persistent blunting of the costophrenic angles compatible with small effusions or scarring. No new findings. | Slightly improved lower zone interstitial opacities with probable small effusions. |
Generate impression based on medical findings. | History of perirectal mass with sciatica and pelvic fluid collection. PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Foley catheter within a collapsed bladder. In the vesicouterine pouch there is a heterogeneous complex fluid collection with irregular peripheral thick-walled enhancement with restricted diffusion compatible with an abscess measuring 4.8 x 4.1 cm (series 1101/71).LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: In the presacral space there is a bilobed cystic lesion measuring 4.5 x 3.9 cm (series 1101/60) demonstrating thin peripheral enhancement. More superiorly and to the right of midline involving the right piriformis muscle there is a 1.6 x 1.3 cm fluid collection with extensive peripheral enhancement and soft tissue edema which extends into the sacral neuroforamen. There is presacral edema.BONES, SOFT TISSUES: Large right-sided Tarlov cysts.OTHER: No significant abnormality noted. | 1. Vesicouterine pouch complex 4.8 cm abscess. 2. 1.6 cm fluid collection in the right piriformis muscle with extensive surrounding inflammatory enhancement and edema. An underlying mass lesion cannot be excluded.3. Inferior presacral cystic lesion measuring 4.5 x 3.9 cm also likely represents an infected fluid collection. |
Generate impression based on medical findings. | Male, 32 years old. Reason: lung eval History: lung eval Support devices are unchanged in position.Heart size remains stable. Multifocal basilar opacities of atelectasis without significant change. No pneumothorax. | Basilar opacities without significant change. |
Generate impression based on medical findings. | 77-year-old male with history of weakness. Evaluate for pneumonia. The cardiomediastinal silhouette is unremarkable. There is mild blunting of bilateral costophrenic angles likely representing very small pleural effusions or scarring. No focal air space opacities or pneumothorax. | No specific evidence of infection. |
Generate impression based on medical findings. | History of renal transplant complicated by postoperative MI and perforated diverticulitis status post Hartman's now with rising LFTs. ABDOMEN: The study is slightly limited by respiratory motion.LIVER, BILIARY TRACT: Contracted gallbladder containing gallstones. Numerous small stones in the distal cystic duct and within the common bile duct. No significant upstream biliary ductal dilatation.No suspicious liver lesion. Evaluation of the vasculature is limited respiratory motion. The main portal vein is grossly patent.SPLEEN: No significant abnormality noted.PANCREAS: The pancreas is atrophic with mild loss of intrinsic T1-weighted signal intensity. Peripancreatic inflammatory fluid and smaller collections are noted. The largest extends along the ventral aspect of the pancreatic body cranially measuring up to 4.0 x 2.9 cm in maximal cross-section and demonstrating T2 hyperintense fluid signal intensity.Note is made of pancreatic divisum. No significant pancreatic ductal dilatation. The parenchyma enhances homogeneously without evidence of parenchymal necrosis or hemorrhage. No evidence of arterial pseudoaneurysm formation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral simple appearing cysts. No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Moderate bilateral pleural effusions. | 1.Contracted gallbladder with numerous gallstones. Choledocholithiasis without upstream significant biliary ductal dilatation.2.Stigmata of pancreatitis including peripancreatic inflammatory fluid and small fluid collections. Pancreas divisum.3. Moderate bilateral pleural effusions. |
Generate impression based on medical findings. | Check for hydropneumothorax. Right pleural effusion Moderate right pleural fluid collection again is observed without evidence of associated pneumothorax. Decreased lung volumes elevated hemidiaphragm is also identified accentuating the appearance.Overall mildly improving aeration with otherwise persistent interstitial and airspace changes suggesting resolving edema and CHF. Mild cardiomegaly | Resolving CHF with persistent moderate right effusion |
Generate impression based on medical findings. | Shortness of breath No cardiopulmonary abnormality | Normal |
Generate impression based on medical findings. | Female, 61 years old.Reason: Night Sweats, Chronic Steroid Use. R/O TBC. History: Night Sweats, Chronic Steroid Use. R/O TBC. No acute cardiopulmonary abnormality. Calcified granuloma left upper lobe. Specifically no evidence of active TB. | No acute cardiopulmonary abnormality. Specifically no evidence of active TB. |
Generate impression based on medical findings. | Female, 74 years old.Reason: dyspnea History: as above Left upper lobe airspace and interstitial opacity with an associated small pleural effusion. There is associated volume loss raising the question of bronchial obstruction. There may be a cyst or pneumatocele in the left but is incompletely evaluated. The right lung is negative. | Left upper lobe airspace and interstitial opacity with an associated small pleural effusion. There is associated volume loss raising the question of bronchial obstruction. In an acute presentation a pneumonia may have this appearance however the findings are suspicious for a lung cancer and follow up with contrast enhanced chest and upper abdomen CT should be considered for better characterization. Findings were discussed with Dr. Stern at the time of report. |
Generate impression based on medical findings. | Female, 38 years old.Reason: increasing o2 requirement History: as above Unchanged basilar opacities and pleural effusions.Right jugular catheter, tip at right atrial level. | Unchanged pulmonary opacities suggestive of edema or aspiration with pleural effusions and atelectasis. |
Generate impression based on medical findings. | Change in mental status. SHUNT DEVICE: A ventriculoperitoneal shunt device has its intracranial tip near the midline and exits the skull via a left frontoparietal burr hole. The shunt tubing descends along the left occipital region, through the left neck, through the anterior soft tissues of the anterior chest and terminates in the pelvis without evidence of kinking or discontinuity.A lumboperitoneal shunt enters the spinal canal at the L3-L4 level and ascends before looping and terminating near the T12 level. The extraspinal portions of this catheter courses along the right flank where a pressure valve device is present. The catheter terminates in the right hemipelvis. No areas of catheter kinking or discontinuity identified.SKULL: Postsurgical changes of right-sided craniotomy and left frontal parietal burr hole.CERVICAL SPINE: No significant abnormality noted.CHEST: No significant abnormality noted.ABDOMEN: Nonobstructive bowel gas pattern. | Ventriculoperitoneal and lumboperitoneal shunts without kinking or discontinuities in the radiopaque portions of the shunt catheters. |
Generate impression based on medical findings. | Male 52 years old Reason: evaluate for evidence of small bowel obstruction History: epigastric abdominal pain and 5 days of constipation No focal pulmonary opacity. Heart size is enlarged.Bowel gas pattern is nonobstructive. Above average stool burden. Surgical changes with clips in the right upper abdomen. There are posttraumatic changes with multiple left healed rib fractures | Above-average stool burden. |
Generate impression based on medical findings. | Left lower extremity weakness. Evaluate for acute injury to cervical spine following laminectomy and C5 tumor resection. History of NF 2. There are interval postsurgical changes of C3-C6 laminectomies related to resection of a relatively large right sided schwannoma at C4-C5 with intraspinal extension. The intraspinal component has been resected with residual tumor within the neural foramen and lateral aspect of the spinal canal at the C4-C5 level again seen. There is T2 hyperintensity involving the right aspect of the cervical cord which has increased/become more apparent since prior study from 3/8/2016. There is an extra-axial collection in the dorsal epidural space extending from the C5-C7 levels which completely effaces the dorsal thecal sac and is associated with increased flattening of the cervical cord compared to prior. There is also associated T2 hyperintensity in the cervical cord extending from the C5-C6 to C6-C7 levels bilaterally, left greater than right, which is increased since prior.Limited images of the brain again demonstrates an enhancing lesion likely representing schwannomas at the right jugular foramen. Small extra-axial lesion along the left anterolateral surfaces of the medulla is also noted which may represent a meningioma.There is mild retrolisthesis of C3 on C4 and anterolisthesis of C4 on C5 as seen before. Focal kyphosis at the C5-C6 level is also again seen. Vertebral body heights are maintained. Bone marrow signal is benign. Enhancing mass is present at the right C1-C2 level with intraspinal extension and effacement of the right lateral thecal sac which is stable to minimally more prominent than before.. Two small enhancing intramedullary lesions are seen within the cord at the C1-C2 and mid C2 levels suspicious for tumor as before. Additional tiny nodules of enhancement are also seen inferior medulla and possibly in the mid and lower cervical cord. Individual levels as below:C2-C3: Enhancing left nerve root with mild expansion of the neural foramen. There is an extramedullary lesion involving the left anterolateral aspect of the spinal canal without significant mass effect on the cord as before and possibly contiguous with the left foraminal lesion.C3-C4: No enhancing lesions. No spinal or neuroforaminal stenosis. C4-C5: Partial tumor resection with residual tumor involving the right lateral aspect of the spinal canal and right neural foramen. There remains leftward displacement of the cord as well as local mass effect on the right lateral aspect of the cord, but improved since prior.C5-C6: Large, predominantly extraforaminal lesion on the right unchanged. Small enhancing extra foraminal lesion on the left is likely unchanged. No spinal canal stenosis.C6-C7: Small,predominantly extraforaminal enhancing lesions bilaterally without expansion of the foramina are likely unchanged. No spinal canal stenosis.C7-T1: Small predominantly extraforaminal enhancing lesions without expansion of the foramina, likely unchanged. No spinal canal stenosis.Additional smaller schwannomas partially visualized within the thoracic spine. | 1. Interval postsurgical changes of C3-C6 laminectomies related to resection of a relatively large right sided schwannoma at C4-C5 with intraspinal extension. The intraspinal component has been resected with residual tumor within the neural foramen and lateral aspect of the spinal canal at the C4-C5 level again seen. 2. There is T2 hyperintensity involving the right aspect of the cervical cord at the C4-C5 level which has increased/become more apparent since prior study from 3/8/2016. 3. There is a fluid collection in the dorsal epidural space extending from the C5 to C7 levels which is associated with worsened effacement of the dorsal thecal sac and increased flattening of the cervical cord compared to prior. There is also associated T2 hyperintensity in the cervical cord extending from the C5-C6 to C6-C7 levels bilaterally, left greater than right, which is increased since prior.4. Stigmata of neurofibromatosis with multiple additional schwannomas, meningioma, as well as intramedullary lesions which may represent representing ependymoma similar to prior. |
Generate impression based on medical findings. | 58-year-old male patient with severe dermatomyositis with proximal muscle wasting. Evaluate muscle mass. ROTATOR CUFF: There is mild thickening and increased signal intensity within the distal fibers of the supraspinatus tendon consistent with mild tendinosis, but no full-thickness tear. There is increased signal intensity within the supraspinatus muscle with minimal muscle atrophy. The tendons of the infraspinatus, teres minor, and subscapularis are intact. The muscles of the infraspinatus, teres minor, and subscapularis demonstrate increased signal intensity on T2-weighted images with minimal atrophy, more pronounced in the subscapularis.SUPRASPINATUS OUTLET: Mild osteoarthritis affects the acromioclavicular joint. There is no significant fluid within the subacromial/subdeltoid bursa.GLENOHUMERAL JOINT AND GLENOID LABRUM: Glenohumeral joint alignment is within normal limits. The labrum appears intact. There is a small glenohumeral joint effusion. Degenerative cysts are noted within the posterolateral humeral head.BICEPS TENDON: The long head of the biceps tendon appears intact. ADDITIONAL | 1. Diffuse signal abnormality within the visualized musculature of the right shoulder consistent with inflammation and provided history of dermatomyositis.2. Supraspinatus tendinopathy but no full thickness rotator cuff tear.3. Small glenohumeral joint effusion. |
Generate impression based on medical findings. | Male, 58 years old.Reason: please asses lung fields History: intubated s/p ECMO decannualtion, MVR Endotracheal tube terminates 3 cm above the carina. Remaining support devices are unchanged.Improved aeration right upper lobe with residual diffuse airspace opacities that are nonspecific. Cardiomegaly and small pleural effusions are unchanged. | Improved aeration right upper lobe with residual diffuse airspace opacities. |
Generate impression based on medical findings. | Female, 74 years old.Reason: 74F with COPD in MICU, leukocytosis, ?aspiration History: 74F with COPD in MICU, leukocytosis, ?aspiration Surgical clips are noted over the trachea. Lumbar immobilization hardware is partially visualized.Persistent low lung volumes with basilar consolidation, pleural effusions and atelectasis. No interval pneumothorax. The cardiac silhouette is obscured | No change in the basilar opacities suspicious for pneumonia. |
Generate impression based on medical findings. | Female 56 years old Reason: Chest pain and shortness of breath History: CP Small volumes.Stable cardiomediastinal silhouette.Bibasal streaky opacities.No other focal airspace opacities.No significant pleural effusion. | Bibasal atelectasis and/or scarring without significant change from prior exam. |
Generate impression based on medical findings. | Reason: Eval for strange luceny on left History: Lucency on left A previously described curvilinear lucency of the left apex is no longer visible and may have been due to a skin fold.ET tube, venous catheter and NG tube unchanged.Bilateral mainly lower zone nonspecific opacities consistent with consolidation atelectasis and effusion, also unchanged. | No evidence of pneumothorax or other acute change. |
Generate impression based on medical findings. | Reason: r/o infiltrate History: cough/gever New right lower lobe airspace opacity, compatible with pneumonia.Heart size without upper normal with a tortuous calcified aorta. | Right lower lobe pneumonia. |
Generate impression based on medical findings. | Metastatic base of tongue squamous cell carcinoma, treated with pembrolizumab, palliative RT to left orbit, and started palliative carbo/paclitaxel/cetuximab. The left cerebellar tonsil lesion is now less conspicuous. However, there are now several new and/or more conspicuous, but subcentimeter lesions elsewhere in the bilateral cerebellar hemispheres and right anterior frontal lobe, without discernible vasogenic edema. The left posterior globe lesion is no longer discernible. There is no evidence of acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull and scalp soft tissues are grossly unremarkable. There is a left maxillary sinus retention cyst. | 1. Interval evolution of the subcentimeter left cerebellar tonsil metastasis, likely due to treatment effects. However, there are now several new and/or more conspicuous, but subcentimeter lesions in the bilateral cerebellar hemispheres and right anterior frontal lobe, which may represent additional metastases.2. The left ocular metastasis is no longer discernible. |
Generate impression based on medical findings. | Age: 19 yearsGender: FemaleReason for Study: Reason: Acute chest? History: sickle cell pain crisis Cardiac mediastinal silhouette is unremarkable.Decreased lung volumes with minimal basilar atelectasis.No focal areas of consolidation.No pleural effusions.Osseous changes compatible with sickle cell disease. | Decreased lung volumes with scattered areas of scarring/discoid atelectasis. No specific evidence of infection. |
Generate impression based on medical findings. | Male, 83 years old.Reason: hx of bladder cancer, evaluate for metastatic disease Cardiomediastinal silhouette was unremarkable. Low lung volumes. No pleural effusions or pneumothorax. No suspicious pulmonary nodules or masses. | No suspicious pulmonary nodules or masses. |
Generate impression based on medical findings. | Male, 62 years old.Reason: s/p AVR History: SOB Tiny right apical pneumothorax again noted. Subsegmental atelectasis or scarring again noted at the left lung base. Small right pleural effusion versus thickening, as before. Unchanged cardiomegaly. Patient status post sternotomy. | No substantial change in tiny right apical pneumothorax compared to previous study. No definite left apical pneumothorax. |
Generate impression based on medical findings. | 60 year-old male with history of prostate cancer status post prostatectomy, now with back and lower extremity pain. Evaluate for lymphocele or other process. CHEST:LUNG BASES: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: There are multiple subcentimeter hypoattenuating lesions in the left liver lobe, which are presumably benign but too small to characterize.A hypoattenuating lesion seen in liver segment 7 measures 1.8 cm by 1.8 cm (image 31, series 3). This lesion is incompletely characterized on this limited study. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Clean left nephrectomy siteRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No evidence of abscess, bowel, obstruction or ileus.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Mild ascitesPELVIS:PROSTATE, SEMINAL VESICLES: The prostate has been surgically removed with surgical clips seen in the resection site.BLADDER: No significant abnormality noted.LYMPH NODES: No pelvic lymphadenopathy noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: There is a minimal amount of pelvic fluid.There is a right hypoattenuating retroperitoneal focus in the external iliac region measuring 1.1 cm x 1.9 cm best seen on image 114, series 3. | 1.Status post radical prostatectomy with mild ascites and postoperative changes as described above2.Right retroperitoneal focus may represent a small lymphocele; however, an enlarged lymph node cannot be ruled out. There should be special attention to this area on future scans.3.Multiple, bilobar liver lesions best considered indeterminate and incompletely characterized, although these lesions would be unusual for metastatic prostate cancer. A dedicated liver scan could further characterize these lesions. |
Generate impression based on medical findings. | 36 week old infant with apnea; evaluate for bleed. There is no evidence of intracranial hemorrhage, mass or edema. The ventricles and basal cisterns are normal in size and configuration.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.Subtle areas of questionable low attenuation within the subcortical white matter and bilateral frontal lobes that could represent prior hypoxic injury; recommend follow up MRI if clinically indicated. | Subtle areas of questionable low attenuation within the subcortical white matter in bilateral frontal lobes that could represent prior hypoxic injury; recommend follow up MRI if clinically indicated. |
Generate impression based on medical findings. | Reason: thyroid nodule(s) History: none RIGHT LOBE MEASUREMENTS: 5.9 x 3.0 x 3.4 cmLEFT LOBE MEASUREMENTS: 5.3 x 1.2 x 1.2 cmISTHMUS MEASUREMENTS: 0.6 cmRIGHT LOBE: A dominant right predominantly solid heterogenous nodule measures 2.8 x 3.3 x 4.1 cm with mild internal vascularity and no definite microcalcifications.LEFT LOBE: In the posterior mid left thyroid there is a 1.2 x 0.8 x 0.9 cm hypoechoic nodule with macrocalcifications and no definite internal vascularity. Another smaller hypoechoic nodule is seen inferiorly measuring 0.4 x 0.4 x 0.5 cm with no vascularity or microcalcifications.ISTHMUS: 2 similar-appearing hypoechoic Isthmus nodules are seen, with no internal vascularity or definite microcalcifications, the largest measuring 0.8 x 0.6 x 1.3 cmPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multinodular thyroid as above. The dominant right and calcified left nodule are amenable to percutaneous biopsy. |
Generate impression based on medical findings. | Male, 66 years old.Reason: Respiratory Failure, Ascitres, Bile Leak History: Respiratory Failure, Ascitres, Bile Leak Endotracheal tube terminates 2 cm above the carina. Other lines and tubes are unchanged. Low lung volumes, as before. Increased diffuse pulmonary opacities. Increased right pleural effusion. Probable small left pleural effusion again noted. Heart size is difficult to assess but is not substantially different. | Worsening in diffuse pulmonary opacity most consistent with pulmonary edema. Increased right pleural effusion. Small left pleural effusion again noted. Lines and tubes, as above. |
Generate impression based on medical findings. | Age: 72 yearsGender: MaleReason for Study: Reason: chest discomfort, worsening with allergy season. Eval for lung disease. History: chest discomfort, needs to take deeper breaths The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.Moderate degenerative changes throughout the thoracic spine. | No acute cardiopulmonary abnormalities are identified. |
Generate impression based on medical findings. | Reason: eval ETT, lung fields History: s/p heart transplant ET tube tip approximately 1 cm above the carina.Swan-Ganz catheter tip in the right main pulmonary artery.Cardiomegaly with pleural effusions and atelectasis, unchanged.No new findings. | Low position of ET tube. |
Generate impression based on medical findings. | Female, 50 years old.Fever question infiltrates. Asthma exacerbation. Interval removal of right chest tube. Large loculated appearing air collection in the projection of the right major fissure superior aspect. Unchanged scarring and volume loss in the right costophrenic angle.Diffuse bronchiolitis. Patchy air space opacity in the retrocardiac region.A subsequent CT has been performed and will be reported separately.Tracheostomy tube tip at the level of the clavicular heads.Large volume of bowel gas in the transverse colon. | Bronchiolitis with air space opacity suspicious for bronchopneumonia. Persistent loculated air collection in the region of the right major fissure. |
Generate impression based on medical findings. | 16-year-old male with history of rotational trauma 4 weeks ago and pain. Evaluate for lateral meniscal tear. MENISCI: The medial meniscus is normal in signal and morphology. There is mild blunting of the free edge of the posterior horn and body of the lateral meniscus; there is no definite increased signal extending to the articular surfaces.ARTICULAR CARTILAGE AND BONE: Mildly increased T2 signal within the lateral femoral condyle and posteriolateral aspect of the lateral tibial plateau compatible with mild edema. Otherwise, no evidence of acute fracture. No evidence of articular cartilage defects.LIGAMENTS: Mildly increased T2 signal within the anterior cruciate ligament fibers which may represent a mild sprain; otherwise, the anterior and posterior cruciate ligaments are intact. The collateral ligaments are intact.EXTENSOR MECHANISM: The quadriceps mechanism is intact.ADDITIONAL | 1.Blunting of the free edge and body of the posterior horn of lateral meniscus without discrete tear.2.Moderate size knee joint effusion.3.Mild osseous contusions involving the lateral femoral condyle and posteriolateral tibial plateau. |
Generate impression based on medical findings. | Male, 30 years old.Chest pain status post motor vehicle collision. The cardiomediastinal silhouette is within normal limits. No displaced rib fracture, focal airspace opacity, significant pleural effusion, or pneumothorax. The spine is inadequately evaluated. | No acute cardiopulmonary abnormality or displaced rib fracture.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | Stage III B cervical poorly/moderately differentiated adenocarcinoma. PELVIS:UTERUS, ADNEXA: The uterus measures 5.1 x 2.9 cm in the sagittal plane, within normal limits for a postmenopausal patient.The endometrium measures 3 mm in thickness, within normal limits.The endometrium/inner myometrial junction is well-defined. The fundus there is a well-defined 1.1 cm T1 iso and T2 hypoechoic lesion compatible with a intramural/submucosal fibroid.The cervical stroma demonstrates normal intermediate T2-weighted signal intensity without a discrete lesion. Postcontrast and restricted diffusion images demonstrate no discrete measurable lesion. The parametrial soft tissues are unremarkable.The adnexa are unremarkable. BLADDER: No significant abnormality noted.LYMPH NODES: Interval decrease in size of pelvic lymph nodes. The left internal iliac lymph node measures 0.9 x 0.6 cm (series 601/46), compared to 1.3 x 0.8 cm previously (series 3/3).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval marked decrease in the cervical mass lesion seen on the prior outside MRI dated 10/8/2015 without a measurable residual lesion. The parametrial soft tissues are unremarkable. The pelvic lymph nodes, including a previously mildly enlarged FDG avid left internal iliac lymph node has decreased in size. |
Generate impression based on medical findings. | Male 52 years old Reason: RUQ pain History: RUQ pain LIMITED ABDOMENLIVER: The liver has a smooth contour. Liver measures 17.2 cm in length. The parenchyma is mildly echogenic . No suspicious hepatic lesions. Main portal vein is patent.BILIARY TRACT: The gallbladder has echogenic calculi with posterior acoustic shadowing. Wall measures 4 mm in thickness. There is pericholecystic fluid. Common duct measures 4.5 mm . PANCREAS: The imaged head of the pancreas is normal. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney measures 9.9 cm. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. The left kidney measures 10.2 cm. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 9.4 cm. in length. OTHER: Trace upper abdominal ascites. | 1.Findings of acute cholecystitis with gallbladder wall thickening, pericholecystic fluid and calculi.2.Findings discussed with Dr. Bass |
Generate impression based on medical findings. | Age: 85 yearsGender: FemaleReason for Study: Reason: worsened shortness of breath r/o CHF History: no LEE, no crackles, r/o COPD vs. CHF Stable cardiomediastinal silhouette.Mild basilar scarring without focal airspace opacities.Blunting of the costophrenic angles unchanged from multiple exams. | Stable mild cardiac enlargement without specific evidence of infection or edema. |
Generate impression based on medical findings. | Age: 86 yearsGender: MaleReason for Study: Reason: eval for PNA History: sob The cardiomediastinal silhouette is unremarkable.Multiple calcified granulomas redemonstrated.Decreased lung volumes with basilar atelectasis similar to the prior exam.No focal airspace consolidation.No pleural effusions. | No acute cardiopulmonary abnormalities identified without interval change. No specific evidence of infection. |
Generate impression based on medical findings. | Female, 68 years old.Reason: sp thoracentesis, assess for pneumothorax History: sob Improvement in left pleural effusion with no pneumothorax.Improved left base consolidation, the lungs otherwise unchanged with suggestion of mild interstitial edema. | No pneumothorax following left thoracentesis. |
Generate impression based on medical findings. | Age: 69 yearsGender: FemaleReason for Study: Reason: eval for effusion, infection History: dyspnea The cardiac mediastinal silhouette is unremarkable.Decreased lung volumes with scattered areas of scarring/discoid atelectasis.Moderate left-sided pleural effusion with left retrocardiac consolidation/atelectasis.Multiple surgical clips noted in the right superior mediastinum. | Left pleural effusion with left retrocardiac consolidation/atelectasis. CT of the chest with IV contrast would be of value. |
Generate impression based on medical findings. | 6-day-old male born at 24 weeks gestation with respiratory distress.VIEW: Chest AP (one view) 10/17/2016, 2212 ET tube tip is between thoracic inlet and carina. Enteric tube tip in the stomach with sidehole in the distal esophagus. Right upper extremity PICC tip in the right brachiocephalic vein. Two right-sided chest tubes are present. Removal of left-sided chest tube. Umbilical arterial catheter tip at level of L1. No umbilical venous catheter is visualized.Cardiothymic silhouette is normal. Right subpulmonic pneumothorax is increased with depression of the right hemidiaphragm and leftward mediastinal shift. No left pneumothorax. Mild hazy opacities bilaterally on a background of pulmonary interstitial emphysema. Moderate soft tissue edema is present. | 1. Increase in size of the right subpulmonic pneumothorax.2. Mild hazy opacities bilaterally on a background of pulmonary interstitial emphysema.3. Enteric tube sidehole in the distal esophagus. |
Generate impression based on medical findings. | Female, 22 years old.Reason: evaluate for infection History: cough for 2 weeks Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Normal heart size. | No acute cardiopulmonary process on radiography. |
Generate impression based on medical findings. | Reason: pneumonia? History: copd w new o2 req't and cough Moderate cardiomegaly with a tortuous aorta.Large lung volumes consistent with COPD.New diffuse interstitial opacity, increased compared to previous, compatible with edema with small bilateral pleural effusions.Calcified granuloma in the right upper lobe compatible with previous infection. | Pulmonary edema and small pleural effusions. No specific evidence of pneumonia. |
Generate impression based on medical findings. | Female, 73 years old.AMS, elevated LA, elevated WBC. Right pleural catheter with tip at the apex. Right basal consolidation about the same. Interval increase in right pleural fluid volume, now moderate. No pneumothorax.Postsurgical volume loss on the left with a small pleural effusion and faint nodules unchanged. | Right basal airspace opacities nonspecific and may reflect infection or metastatic disease in this patient with known neoplasm. |
Generate impression based on medical findings. | There is interval decrease in the size of some of the cystic components of the craniopharyngioma. The cystic component that was noted in the previous study and indenting of the undersurface of the right frontal lobe decreased in size from 12 mm previously to 6 mm currently, deforming the lateral right cerebral peduncle has decreased in size from 19 x 13 mm previously to 11 x 7 mm currently. The cystic components along the anterior aspect of the right cerebral peduncle and along the anterior aspect of the left cerebral peduncle have also decreased in size. There continues to be involvement of the prepontine, cerebellopontine angle cistern, right ambient and right quadrigeminal cisterns, as well as the right middle cranial fossa, with associated mass effect upon the brainstem, right medial temporal lobe, and hypothalamus-optic apparatus complex. There is asymmetric volume loss of the left cerebellar hemisphere associated with increased T2 signal, which may be attributable to crossed cerebellar diaschisis versus chronic ischemic effects. The basilar artery is tortuous and encased by the tumor. There are postoperative findings related to right temporal craniotomy and stable position of right transfrontal catheter with the tip in the right prepontine cyst. The ventricular system appears to be unchanged. There are foci of susceptibility effect within the right temporal lobe resection cavity, consistent with hemosiderin deposition, and within portions of the tumor, which likely represent calcifications. | Further regression of some of the peripheral cystic components of the complex suprasellar and posterior fossa craniopharyngioma. |
Generate impression based on medical findings. | Male, 69 years old.Reason: 69 yo with PICC line in the right arm, place verify position of the of the catheter History: nausea and vomiting Interval placement of a large caliber left bronchial stent, the relationship with the left upper lobe bronchus unclear from this examination.Unchanged mid-esophageal stent.Stable left hemithorax volume loss.Unremarkable right lung.Right PICC, tip in axilla. | New left bronchial stent, relationship with the upper lobe bronchus origin unclear from this examination but possibly extending beyond this. |
Generate impression based on medical findings. | 60-year-old female with flank pain. Reason: Evaluate for renal obstruction. RIGHT KIDNEY: The right kidney measures 10.5 cm. Echogenic parenchyma without mass, stone, or hydronephrosis.LEFT KIDNEY: The left kidney measures 11.1 cm. Echogenic renal parenchyma. Moderate hydronephrosis.OTHER: The bladder is nondistended. Redemonstrated pelvic mass as seen on prior study. There is also a perinephric mass adjacent to the left kidney measuring 4.8 x 4.4 x 6 cm, also seen on prior study. | 1. Moderate hydronephrosis of the left kidney associated with perinephric mass.2. Echogenic renal parenchyma compatible with medical renal disease/parenchymal dysfunction.3. Redemonstrated pelvic mass as seen on prior study. |
Generate impression based on medical findings. | Prekidney transplant No cardiopulmonary abnormality | Normal |
Generate impression based on medical findings. | 62-year-old male with mildly elevated creatinine of 1.6. Evaluate for renal abnormalities. This examination is limited by absence of oral and intravenous contrast.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple bilateral renal pelvic calcifications are nonobstructive. Bilateral renal cysts. In the left midpole region dorsally there is a 1.4-cm partially exophytic solid lesion. This may be more fully evaluated with dedicated contrast enhanced CT or MRI examination. The lesion is best seen at axial image 36 of series 3 adjacent to a large benign simple cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Degenerative changes in the lower lumbar spine and pelvis.OTHER: No significant abnormality noted | No acute abnormality to explain the elevation in creatinine. Suspicious left midpole lesion may be an occult renal mass, so contrast enhanced dedicated kidney MRI or CT exam is recommended for further evaluation. |
Generate impression based on medical findings. | Male, 50 years old.Reason: s/p cardiac surgery History: s/p cardiac surgery ET tube tip approximately 6 cm from the carina.Other support devices unchanged.Pulmonary edema and subsegmental atelectasis is unchanged.Stable moderate cardiomegaly. | Stable support devices and cardiopulmonary appearance. |
Generate impression based on medical findings. | 38 years, Female, facial twitching. Again seen are numerous periventricular and subcortical white matter T2/FLAIR hyperintense lesions in both hemispheres of the brain. Multiple infratentorial lesions including the brainstem, middle cerebellar peduncles, and cerebellar hemispheres are also again seen. Extent of confluent signal abnormality may limit detection of small new lesions, but there are at least 2 new lesions including the right inferior aspect of the mid callosal body (axial series 401 image 59, sagittal series 301 image 100) as well as the left frontal corona radiata (axial series 401 image 55, sagittal series 301 image 71). Upper cervical lesions are again seen but not well assessed.There is mild to moderate degree of parenchymal volume loss with thinning of the corpus callosum. There is a moderate burden of T1 hypointense lesions. No intracranial mass effect, midline shift, or herniation. No hydrocephalus. Major flow-voids are preserved. Calvarium and extracranial soft tissues are grossly unremarkable. | Numerous chronic supratentorial and infratentorial demyelinating lesions with at least two new lesions since 11/9/2015 as described above. |
Generate impression based on medical findings. | Male, 65 years old.Reason: swan placement History: swan placement Unchanged basilar edema and left lower lobe atelectasis.Right jugular Swan-Ganz catheter, tip in right main pulmonary artery.Right PICC, tip in the SVC.Left PICC, tip in the SVC. | Right jugular Swan-Ganz catheter, tip in right main pulmonary artery. Unchanged edema and left basilar atelectasis. |
Generate impression based on medical findings. | Age: 52 yearsGender: MaleReason for Study: Reason: pleural effusions History: pleural effusions Tracheostomy tube with its tip 4 cm above the carina.Left IJ venous catheter with its tip now in the left innominate.Pleural effusions and left retrocardiac consolidation/atelectasis similar to the prior exam.No new pulmonary opacities identified. | Mild retraction of left IJ venous catheter. Stable cardiopulmonary appearance of pleural effusions and left retrocardiac consolidation/atelectasis. |
Generate impression based on medical findings. | Female, 71 years old.Reason: 71yo F w/ ESRD, COPD s/p extubation History: as above Right jugular catheter through right brachiocephalic stent unchanged. Interval removal of nasogastric tube and endotracheal tube.Large lung volumes consistent with COPD with coarse interstitial opacity, unchanged. No new opacity to suggest pneumonia. | Large lung volumes consistent with COPD with coarse interstitial opacity, unchanged. No new opacity to suggest pneumonia. |
Generate impression based on medical findings. | Patient has depth electrodes placed for intracranial EEG monitoring on 10/8/15.Evaluate for depth electrode position. There are two left transfrontal electrodes that extend to the left anterior cingulate and left orbitofrontal region. There are also bilateral transparietal electrodes that extend to the bilateral medial temporal lobes. There is a small amount of pneumoventricle. The ventricular system is otherwise unchanged in size. There is a small amount of high T1 signal in the right parietal sulci adjacent to the electrode, which may represent postoperative enhancement or hemorrhage. There is no midline shift or herniation. There is mild scalp swelling surrounding the electrode insertion sites. | Two left transfrontal electrodes that extend to the left anterior cingulate and left orbitofrontal region and bilateral transparietal electrodes that extend to the bilateral medial temporal lobes. |
Generate impression based on medical findings. | Female, 81 years old.Reason: 81yoF w/ pleural effusions on cxr History: cough, pleural effusions Cardiac silhouette upper limits normal. Streaky basilar opacities representing atelectasis. No pleural effusion. No pneumothorax.No change in appearance of VP shunt catheter. | Basilar atelectasis. No other interval change. |
Generate impression based on medical findings. | Reason: pulm edema History: as above Moderately severe cardiomegaly, but no sign of pulmonary edema or infection.Catheter tip in the SVC. | Cardiomegaly with no acute findings. |
Generate impression based on medical findings. | Female 20 years old Reason: 20F with sickle cell, now with septic shock and rising bilirubin History: see above LIMITED ABDOMENLIVER: The liver has a smooth contour. Liver measures 20 cm in length. The parenchyma is mildly echogenic . No suspicious hepatic lesions. Main portal vein is patent.BILIARY TRACT: The gallbladder has echogenic calculi with posterior acoustic shadowing. Wall measures 3 mm in thickness. Common duct measures 4 mm. PANCREAS: The pancreas is obscured due to bowel gas.KIDNEYS: The right kidney measures 14.3 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. The left kidney measures 13.3 cm. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 7.1 cm. in length. OTHER: No ascites | 1.Hepatomegaly without biliary ductal dilatation.2.Scattered gallstones without ultrasound evidence of cholecystitis.3.Patent portal vein |
Generate impression based on medical findings. | 6-year-old female with history of neuroblastoma, off therapy evaluation. Status post resection, chemotherapy, radiation, stem cell transplant. CHEST:LUNGS AND PLEURA: No nodules, air space opacity, or pleural effusions.Linear calcification along the pleura at the left medial base is unchanged.MEDIASTINUM AND HILA: Soft tissue density in the anterior mediastinum with concave margins with respect to the aorta is unchanged and consistent with normal thymus. No lymphadenopathy. Normal heart size. No pericardial effusion.CHEST WALL: Round structure with a high density rim measuring 7 mm in the left anterior chest wall is unchanged and consistent with a retained cuff from prior central venous catheter. Lucent and sclerotic lesions throughout multiple vertebral bodies are unchanged.ABDOMEN:LIVER, BILIARY TRACT: Homogeneous enhancement without focal lesion. Normal gallbladder. No intrahepatic or extrahepatic biliary ductal dilatation.SPLEEN: Homogeneous enhancement without focal lesion.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Normal cortical enhancement. No pelvocalyceal dilatation.RETROPERITONEUM, LYMPH NODES: Multiple surgical clips in the retroperitoneum. No masses or lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. Normal appendix retrocecal in location.BONES, SOFT TISSUES: Lucent and sclerotic lesions throughout multiple vertebral bodies are unchanged. Bone marrow biopsy tracts in both ilia.OTHER: No free fluid. | No evidence of new disease. Lucent and sclerotic lesions throughout the vertebral bodies are unchanged. |
Generate impression based on medical findings. | MRI Brain:There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.MRA Brain: The intracranial internal carotid, middle and anterior cerebral arteries are patent. The AComA is not well seen by MRI. The left PComA is small. The right PComA is medium sized. The right vertebral artery is bigger than the left but both are patent. The basilar artery and posterior cerebral arteries are patent with no significant stenosis. No evidence of aneurysms or vascular malformations.MRA Neck: There is a separate origin of the left subclavian artery, left common carotid artery, and brachiocephalic artery from the arch. The common carotid arteries and cervical internal carotid arteries are normal in course and caliber. The left vertebral artery is smaller than the right and arises from a common origin with the left subclavian artery from the aorta. Both vertebral artery origins are patent. There is no evidence of stenosis or occlusion. MRI C-Spine:The craniovertebral junction appears within normal limits. The cervical spine alignment is maintained and the cervical vertebral bodies and disc spaces are appropriate in height. The bone marrow signal is within normal limits. The cervical spinal cord has normal signal characteristics and overall morphology. The vertebral artery flow voids appear to be intact. No significant compromise to the spinal canal or neural foramina. The paraspinous soft tissue structures appear within normal limits. | 1.No evidence of acute intracranial hemorrhage, mass or abnormal mass lesion.2.No evidence for cervicocerebral occlusive disease, including no evidence of vertebral or carotid artery dissection.3.No evidence for cervical spinal cord compression or cord signal abnormality. There is no significant compromise to cervical spinal canal or neural foramina4.Tonsilar ectopia which may represent an incidental finding. |
Generate impression based on medical findings. | Reason: lung infiltrate History: SOB Cardiomegaly with bilateral opacities suggestive of edema with pleural effusions.ICD lead extending to the area of the right ventricular apex, unchanged. | CHF. |
Generate impression based on medical findings. | Female, 24 years old.Sickle cell pain. Right chest port with catheter tip in the SVC.Mild cardiomegaly, similar to prior. Unremarkable cardiomediastinal silhouette otherwise.No specific evidence of infection, edema, or acute chest syndrome.No pneumothorax or pleural effusions.Cholecystectomy clips. | No acute cardiopulmonary abnormality evident. No interval change. |
Generate impression based on medical findings. | 63-year-old female with metastatic breast cancer CHEST:LUNGS AND PLEURA: Left apical fibrosis and subpleural cysts likely radiation reaction. No significant change in the scattered pollen MR cannot.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Unchanged left clavicle, sternum and upper thoracic spine findings suspicious for treated metastatic disease. Unchanged soft tissue mass adjacent to the left pectoralis muscle best image number 33, series number 3.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No significant change from previous study. |
Generate impression based on medical findings. | 61 year old female with right lung mass reported on outside exam, history of tobacco use LUNGS AND PLEURA: There is a lobulated 20 mm x 18 mm mass peripherally in the right upper lobe (image 46, series 5).Large right hilar/perihilar mass (image 38, series 5) measures 29 mm x 39 mm. Areas subsequent compression and displacement of the right upper lobe pulmonary artery.Upper lobe ground glass opacity anteriorly, most likely represents aspiration/bronchial plugging. Surrounding bronchi demonstrate wall thickening.Left lung is clear. There is no evidence of a pleural effusion.MEDIASTINUM AND HILA: Prominent pretracheal lymph nodes are noted with reference lymph node (image 25, series 3) measuring 9 mm x 13 mm..Moderate aortic and coronary artery calcifications.Common origin of the innominate and left common carotid arteries.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted. | 1.Lobulated right upper lobe mass and large right hilar mass highly suspicious for primary neoplasm.2.No evidence of distant metastases.3.Several prominent mediastinal lymph nodes. |
Generate impression based on medical findings. | Reason: s/p S-ICD History: s/p S-ICD Normal heart size and mediastinal contours.Presternal ICD lead in place.Mild streaky opacity in both lower lobes medially consistent with subsegmental atelectasis and probable small pleural effusions in the posterior costophrenic angles. | Presternal ICD lead in place with mild basilar atelectasis and probable small effusions. |
Generate impression based on medical findings. | Male, 25 years old.Reason: ? PNA History: HIV and fever Nodular right upper lobe opacity, with some surrounding small nodules.Elsewhere, the lungs are unremarkable except for mild bronchial wall thickening.Status post median sternotomy, heart size normal. | Right upper lobe nodular opacity, the differential diagnosis including tuberculosis, focal bacterial infection or even pulmonary lymphoma given the HIV history. |
Generate impression based on medical findings. | Pneumonia Mild streaky densities in both bases, nonspecific. Changes may represent aspiration or mild atelectasis. Consider serial imaging to improve sensitivity and exclusion of a right lower lobe evolving process. In addition, please note there is a mild asymmetry with asymmetric density partially observed in the right apex, this may be due to rotation and positioning, however comparison with prior imaging if available would be very helpful to confirm stability.The cardiac and mediastinal contours are significant for scattered calcified lymph nodes representing old healed granulomatous disease exposure. | Suspected atelectasis and/or aspiration, the detail provided above and value in comparing to prior outside imaging if available and/or serial imaging. |
Generate impression based on medical findings. | Female, 59 years old.Presenting for prekidney transplant evaluation. Please rule out cardiomegaly. No cardiomegaly. No pleural effusion or pneumothorax is visualized. Basilar stent is redemonstrated in the left axilla. Scarring is visualized in the right lower and left lower lobes. Mild pectus excavatum again noted. | No cardiomegaly or acute cardiopulmonary abnormality. |
Generate impression based on medical findings. | 19-year-old male status post heart transplant with cough. Status post median sternotomy.Left chest wall pulse generator remains stable in position.Stable cardiomediastinal silhouette.No focal pulmonary opacity. Bilateral small pleural effusions. | Bilateral very small pleural effusions. No specific signs of infection. |
Generate impression based on medical findings. | 94 year old male with incidentally noted right atrial vs. pericardial mass Left VentricleThe left ventricle is normal in size with hyperdynamic systolic function. The overall LV ejection fraction is 77%, the LV end diastolic volume index is 49 ml/m2 (normal range: 74+/-15), the LVEDV is 85 ml (normal range 142+/-34), the LV end systolic volume index is 11 ml/m2 (normal range 25+/-9), the LVESV is 19 ml (normal range 47+/-19), the LV mass index is 27 g/m2 (normal range 85+/-15), and the LV mass is 46 g (normal range 164+/-36). There are no regional wall motion abnormalities present. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is mildly enlarged. Right VentricleThe right ventricle is normal in size with hyperdynamic systolic function. The overall RV ejection fraction is 73%, the RV end diastolic volume index is 68 ml/m2 (normal range 82+/-16), the RVEDV is 117 ml (normal range 142+/-31), the RV end systolic volume index is 19 ml/m2 (normal range 31+/-9), and the RVESV is 32 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size. There is lipomatous hypertrophy of the interatrial septum. The interatrial septum is aneurysmal. No atrial mass is seen.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is no significant mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is normal in size. The thoracic aorta is tortuous.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is normal in size.Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsMultiple hemangiomas and/or cysts in the liver. There are bilateral cysts in the kidneys. There is cholelithiasis and gallbladder sludge; mild gallbladder wall thickening . This study is not designed for the specific evaluation of extra-cardiac findings; therefore, the differentiation between artifacts and real extracardiac pathology may be difficult. If clinically indicated, a separate dedicated evaluation should be considered. | 1. Normal size LV with hyperdynamic systolic function (EF 77%).2. Normal size RV with hyperdynamic systolic function (EF 71%).3. Aneurysmal interatrial septum with lipomatous hypertrophy. 4. No right atrial mass visualized. 5. Extra-cardiac findings as above. |
Generate impression based on medical findings. | Male, 59 years old.Reason: change to effusions, chest tube placement, airspace History: bilateral lung txp w bilateral hemothorax The support devices are unchanged in position.Partially loculated moderate right and small left pleural effusions are unchanged. Mid to lower zone edema atelectasis and cardiomegaly also unchanged. No pneumothorax. Gastrostomy balloon projects over the left upper abdominal quadrant. | Stable mid to lower zone edema with partial loculated pleural effusions and mild cardiomegaly. |
Generate impression based on medical findings. | Male, 71 years old.Reason: respiratory insufficiency History: as above Small lung volumes.Azygos pseudolobe.No specific evidence of infection or edema. | No specific evidence of infection or edema. |
Generate impression based on medical findings. | Reason: F/U Pleural Efffusions History: F/U Pleural Efffusions Cardiopulmonary monitoring and support devices, unchanged.Bilateral opacities suggestive of edema and atelectasis with moderate pleural effusions.No pneumothorax. | Moderate bilateral pleural effusions, slightly greater on the left with a right chest tube in place. |
Generate impression based on medical findings. | Obesity and history of fatty liver LIVER: Coarse and echogenic liver parenchyma again noted without mass. Liver length 14.6 cm. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 12.5 cm in lengthOTHER: Left kidney 11.7 cm in length spleen 10.9 cm in length. No ascites | Coarse and echogenic liver parenchyma again noted without change consistent with fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on medical findings. | Female, 62 years old.Reason: please evaluate prior to starting new tx History: metastatic colon cancer Multiple pulmonary nodules consistent with known metastatic colon cancer.Scarlike opacity left apex possibly from prior infection.Heart size normal.No specific evidence of infection or edema.Right subclavian catheter, tip at SVC/RA junction level. | Metastases, without acute findings. |
Generate impression based on medical findings. | Reason: eval for ptx, pneumonia History: frequent falls, FTT Heart size is about upper normal with a tortuous calcified aorta compatible with age. Healed fracture deformities of the right lower anterior ribs.No sign of pneumothorax, pneumonia or other acute change. | No acute abnormalities. |
Generate impression based on medical findings. | 54 year old female. Cirrhosis. Bil dil on ultrasound. ABDOMEN:LIVER, BILIARY TRACT: No suspicious hepatic mass is identified. Patent hepatic vasculature. Mild central intrahepatic dilatation and diffuse marked extrahepatic ductal dilatation measuring up to 18 mm, which has increased from 2011 when it measured 10 mm. Patient will be called back for MRCP images for further evaluation of this biliary dilatation.Blooming artifact next to the ampulla due to a duodenal diverticulum, better seen on prior CT.Questionable nodular thickening near the ampulla (series 1201, image 67), unchanged from 2011 (seen on series 12, image 14), most likely benign and may represent collapsed duodenal folds. Cholecystectomy clips.SPLEEN: No significant abnormality noted.PANCREAS: No pancreatic mass. No pancreatic ductal dilatation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Mild cortical scarring of the left kidney.RETROPERITONEUM, LYMPH NODES: Atherosclerotic disease of the abdominal aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No ascites or varices. | 1.No suspicious hepatic mass.2.Mild central hepatic and diffuse marked extrahepatic biliary ductal dilatation which has increased from 2011. Patient will be called back for MRCP images for further evaluation and addendum will be issued at that time. |
Generate impression based on medical findings. | Female, 61 years old.Reason: pneumonia? History: SOB NG tube tip in stomach, side-port is near the GE junction. Interval extubation.Lungs hypoinflated with no new opacity. | Lungs hypoinflated. No new opacity to suggest pneumonia. |
Generate impression based on medical findings. | Male, 48 years old.Reason: interval changes History: as above Small pleural effusions.Left basilar opacities suggestive of aspiration or pneumonia, increased since the prior study.Left subclavian pacemaker, leads unchanged in position.Right jugular catheter, tip in SVC.ET tube tip approximately 3 cm above the carina. | Increasing left basilar opacity suggestive of infection or aspiration. |
Generate impression based on medical findings. | Female, 87 years old.Reason: Shortness of Breath with exertion; fatigue History: Sarcoid and left breast CA. Previous finding of nonspecific perihilar pulmonary opacities resolved. Residual scarlike opacities in upper lobes; right side may be due to sarcoidosis, left side likely due to radiation therapy. No focal consolidation, effusion, or pneumothorax.Mildly tortuous aorta.Surgical clips noted in left axilla. | Resolution of nonspecific perihilar pulmonary opacities. Residual scarlike opacities unchanged and may be a combination of fibrosis from RT and sarcoid. No acute findings. CT may be of use if clinically warranted. |
Generate impression based on medical findings. | Female, 56 years old.Reason: 56 yo F s/p L sided thoracentesis, eval for PTX History: as above Stable position right IJ central catheter.No significant change in the left greater than right basilar. Moderate layering left pleural effusion. | Stable moderate left pleural effusion and basilar consolidation, left greater than right. |
Generate impression based on medical findings. | 48-year-old male with metastatic transitional cell cancer, now with abdominal pain. ABDOMEN:LUNG BASES: Small left pleural effusion.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Absent native kidneys.RETROPERITONEUM, LYMPH NODES: Extensive retrocrural, retroperitoneal adenopathy is unchanged. Reference right retroperitoneal adenopathy measures 3.1 x 1.6 cm (image 36 series 5) appears similar to previous accounting for slight differences in technique previously measuring 3.2 x 2.2 cm. Reference retrocaval adenopathy measures 2.2 x 1.2 cm, (image 21 series 5) previously 2.2 x 1.3 cm.Stable abdominal aortic aneurysm.BOWEL, MESENTERY: Small bowel wall thickening possibly indicates enteritis, though more likely secondary to ascites.BONES, SOFT TISSUES: Lytic bone lesion in the left iliac wing, unchanged.OTHER: Anasarca and ascites has progressed compared to the previous examination.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Progression of anasarca and ascites.2. No significant change in the extensive retrocrural, retroperitoneal and pelvic adenopathy.3. Other findings stable. |
Generate impression based on medical findings. | Female, 55 years old.Preop MVR with lower extremity edema. At least moderate enlargement of the cardiomediastinal silhouette. Somewhat globular cardiac configuration could indicate the presence of pericardial fluid.Mild pulmonary vascular redistribution but no specific signs of pulmonary edema and no pleural fluid. No focal airspace opacities or pneumothorax. Minimal atelectasis at the right base. | Cardiomegaly with signs of hypervolemia but no convincing evidence of CHF or pneumonia. |
Generate impression based on medical findings. | Shortness of breath and chest pain Minimal basilar atelectasis and/or scarring greater on the left without superimposed additional focal airspace abnormality. Borderline cardiomegaly given technique. Mediastinal contours are otherwise within limits | Minimal atelectasis |
Generate impression based on medical findings. | Reason: ETT and OG tube position History: ETT and OG advanced ET tube tip approximately 3 cm above the carina.NG tube tip in the body of the stomach.Perihilar bronchial thickening with no sign of pneumonia. | ET tube in acceptable position. |
Generate impression based on medical findings. | IABP check IABP marker projects 5 cm from the aortic arch. ETT is observed within 1 cm of the carina. Pager 1613 contactedNG extends beyond the inferior edge of the imageNo additional cardiopulmonary abnormalities. | Over advanced ETT |
Generate impression based on medical findings. | 55 year old man with history of non-ischemic cardiomyopathy, cardiac sarcoid who presents with new drop in EF. Patient presents for cardiac MRI to evaluate cardiac function and extent of sarcoid involvement Left VentricleThe left ventricle is severely dilated with severely reduced systolic function. The overall LV ejection fraction is 12 %, the LV end diastolic volume index is 180 ml/m2 (normal range: 74+/-15), the LVEDV is 337 ml (normal range 142+/-34), the LV end systolic volume index is 157 ml/m2 (normal range 25+/-9), the LVESV is 327 ml (normal range 47+/-19), the LV mass index is 77 g/m2 (normal range 85+/-15), and the LV mass is 160 g (normal range 164+/-36). There is severe diffuse hypokinesis. There is midwall basal to mid septal late gadolinium enhancement not consistent with myocardial infarction. This is likely secondary to underlying fibrosing, infiltrative, or inflammatory process. No evidence of myocardial iron overload. Left AtriumThe left atrium is severely dilated. Right VentricleThe right ventricle is mildly dilated and severely reduced in systolic function. The overall RV ejection fraction is 20%, the RV end diastolic volume index is 129 ml/m2 (normal range 82+/-16), the RVEDV is 269 ml (normal range 142+/-31), the RV end systolic volume index is 104 ml/m2 (normal range 31+/-9), and the RVESV is 216 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThere is reduced excursion of the mitral valve with moderate mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is normal in size.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is normal in size.Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsThere is mediastinal lymphadenopathy present. This study is not designed for the specific evaluation of extra-cardiac findings; therefore, the differentiation between artifacts and real extracardiac pathology may be difficult. If clinically indicated, a separate dedicated evaluation should be considered. | 1. The left ventricle is severely dilated with severely reduced systolic function (LVEF 12%)2. There is a mid-wall stripe of basal to mid septal late gadolinium enhancement. The pattern is atypical for prior myocardial infarction and represents underlying myocardial fibrosis, inflammation, or infiltration. Given the patient's history of sarcoidosis, the underlying mechanism of the late gadolinium enhancement is likely due to sequelae of cardiac sarcoidosis. Would recommend FDG-PET to determine whether active inflammation is present and to guide potential immunosuppressive therapy.3. The right ventricle is mildly dilated and severely reduced in systolic function (RVEF 20%)4. Moderate mitral regurgitation5. Severe left atrial enlargement6. Extra-cardiac findings as above7. In comparison to the cardiac MRI performed 7/14/10, there has been a substantial decrease in systolic function. |
Generate impression based on medical findings. | 74-year-old female with biopsy-proven multifocal right breast invasive ductal carcinoma with metastatic axillary lymph node presents for reevaluation after neoadjuvant therapy. A targeted right ultrasound was performed for the previously identified right breast masses and abnormal right axillary lymph node. In the right breast, 8:00, 3 cm from the nipple, there is a 1.4 x 1.6 x 0.9 cm irregular hypoechoic mass with biopsy clip, previously 1.5 x 1.7 x 2 cm.In the right breast, 9:00, 5 cm from the nipple, there is a 1.1 x 0.5 cm hypoechoic mass. This finding may be a correlate for the previously described 9:00 mass, but is only well seen on one in the transverse dimension. The 9:00 mass previously measured 1.1 x 0.8 x 1 cm.In the right breast, 10:00, 5 cm from the nipple, no sonographic correlates for the two previously described masses are identified.In the right axilla, there is a 1.1 x 0.9 x 1.4 cm abnormal right axillary lymph node with biopsy clip, previously 2 x 1.7 x 1.9 cm. | Interval decrease in size of biopsied right breast 8:00 mass and biopsied right axillary lymph node. Possible correlate for the right breast 9:00 mass is mildly decreased as well. Two previously described masses at the 10:00 position are not visualized.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on medical findings. | Male, 34 years old.Chest and arm pain. Intercostal pain. Evaluate for dissection. Normal heart size. The lungs are clear. No pneumothorax. No suspicious mediastinal widening. Mild scoliosis. | No mediastinal widening or acute pulmonary abnormality. Please note that intravascular pathology may not be visible by plain film technique. |
Generate impression based on medical findings. | 64-year-old male with HCV and cirrhosis ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology, and perihepatic ascites. There is a mass in the right hepatic lobe measuring 2.6 x 2.6 cm with increased T2 signal, enhancement, and washout, consistent with HCC. The portal vein is small caliber but patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Moderate ascites. | 1.2.6-cm right hepatic mass consistent with HCC. The portal vein is small in caliber but appears patent.2.Cirrhotic liver morphology and ascites. |
Generate impression based on medical findings. | Female 33 years old Reason: 33 year old female with left posterior knee swelling, assess for popliteal cyst No significant abnormality noted, no evidence of a Baker's cyst. | Normal examination, no findings seen to explain the patient's symptoms. |
Generate impression based on medical findings. | 62 years, Male. NG tube placement Interval advancement of the enteric tube with sidehole and tip now in the distribution of the proximal gastric body. Esophageal temperature probe are partially seen in the mid esophagus. Lower abdomen and pelvis is excluded from the field-of-view, visualized abdomen appears unremarkable. Please see same day chest radiograph report for thoracic findings. | Enteric tube tip and sidehole in the distribution of the proximal gastric body. |
Generate impression based on medical findings. | Female, 65 years old.Reason: intubated History: intubated Endotracheal tube terminates 4 cm superior to carina. Nasogastric tube is coiled in the stomach, terminating in a cranial direction at the fundus.Heart size remains upper limits normal. No interval pneumothorax or pulmonary edema. | Nasogastric tube is directed toward the gastric fundus. |
Generate impression based on medical findings. | Male, 28 years old.Reason: infectious workup, leukocytosis History: infectious workup, leukocytosis The cardiomediastinal silhouette is normal. No pulmonary opacity, no pleural effusion, no pneumothorax. | No acute cardiopulmonary disease. |
Generate impression based on medical findings. | 6-year-old male status post biopsy, resection, and chemotherapy for alveolar rhabdomyosarcoma. Off therapy evaluation. LUNGS AND PLEURA: The previously described cluster of nodular and scarlike opacity in the right upper lobe appears stable. Likewise, the nodular opacity at the lateral aspect of the right major fissure is unchanged.Ill-defined nodular and tree in bud opacity in the left lower lobe is stable in appearance (image 38/65). No pleural effusions or focal consolidation are seen.MEDIASTINUM AND HILA: Evaluation of lymph node pathology is limited without intravenous contrast. Within this limitation, small pretracheal lymph nodes appear similar in size. No grossly enlarged mediastinal or hilar lymph nodes are evident.The heart size is within normal limits, with no evidence of pericardial effusion.CHEST WALL: A surgical clip is again seen in the right axilla. No pathologically enlarged axillary lymph nodes are seen. No chest wall lesions are evident.No destructive bone lesions are seen.UPPER ABDOMEN: Incomplete views of the upper abdomen are limited by the noncontrast protocol used for the exam. Within this limitation, the previously described subcentimeter round hypodense lesions are not well visualized now. One hypodense subcentimeter lesion in the dome is too small to characterize on image 51/65. | 1. Stable left upper lobe nodular opacity, likely post infectious in etiology.2. Stable right upper lobe nodules and scar.3. Small liver dome hypodensity too small to characterize. |
Generate impression based on medical findings. | Female, 55 years old.Reason: r/o infiltrate History: shortness of breath Unchanged cardiomediastinal silhouette.Stable severe upper lobe predominant emphysema.No focal consolidation, significant pleural effusion or pneumothorax. | Severe emphysema without acute cardiopulmonary abnormality or significant interval change. |
Generate impression based on medical findings. | 72 year old female with acute kidney injury. RIGHT KIDNEY: The right kidney measures 10.6 cm in length without hydronephrosis or shadowing calculus. There is a 3.2 x 8.3 x 3.3 cm inferior pole septated cyst. There is mild cortical thinning. LEFT KIDNEY: The left kidney measures 10.1 cm in length without hydronephrosis or shadowing cavus. There is a 7 mm inferior pole simple appearing cyst. There is mild cortical thinning. URINARY BLADDER: The urinary bladder is nearly completely contracted. | No hydronephrosis. Simple and minimally complex cysts as above. |
Generate impression based on medical findings. | Female, 66 years old.Reason: iABP History: as above Moderate cardiomegaly.No specific evidence of infection or edema.IABP catheter tip projects over the aortic arch.Right jugular catheter, tip in SVC.IVC Swan-Ganz catheter looped in the right atrium before terminating in the main pulmonary artery.Left subclavian ICD, leads unchanged in position. | IABP catheter tip projects over the aortic arch. Swan-Ganz catheter looped in the right atrium. |